Medications and Products to Avoid* in Thalassemia
*The medical literature suggests that these medications and products may cause problems for people with hemoglobin H disease; however, no studies have been conducted to prove that these substances are actually harmful for people with hemoglobin H disease.
In an effort to avoid hemolytic episodes that cause the destruction of red blood cells and lower the hemoglobin level suddenly, it is suggested that the following be avoided. Any type of chemical fumes can be added to this list as to be avoided.
Fava beans, known as favism (some people report problems with other beans and legumes, such as peanuts). If prone to sudden drops in Hb, try keeping a food diary to see if certain foods may be causing hemolysis, the destruction of red blood cells. In general, similar chemical fumes can pose a hemolysis risk in some people. I have even heard anecdotal evidence about chemical fragrances from daily life setting off hemolysis. Fabric softener dryer sheets were mentioned, but again, if Hb suddenly drops, review if there has been any food, drug or chemical exposure that may have set it off.
7/20/14 I have been informed that cigarette smoke can also be a factor that can suddenly reduce the HB level in alpha thalassemics. As always, observation of exposures once you have a hemolytic crisis will tell you what you need to avoid.
Sulfa Drugs
Sulfacetamide (eye drops)
Sulfapyridine
Salfasalazine (Salicylazosulfapyridine)
Sulfanilamide
Dapsone
Analgesics
Aspirin (acetaminophen is safe as alternative)
Phenacetin
Acetanilide
Antimalarials
Primaquine
Chloroquine
Hydroxychloroquine sulfate
Tuberculosis Drugs
Isoniazid
Rifampin
Folic Acid Antagonists
Pyrimethamine
Other Antibacterials
Nalidixic acid (Negram)
Nitrofurantoins
Furazolidone
Chloramphenicol
Beta-amniosalicylic acid
Ciprofloxacin
Doxycycline
Other Items
Iron supplements ¹
Vitamin K analogues
Quinidine gluconate
Phenazopyridine (pyridium)
Toluidine Blue (a dye)
Methylene Blue (a dye)
Naphthalene (mothballs)
¹Unless laboratory-proven iron deficiency.